Scutellari P N, Orzincolo C, Droghetti M, Bedani P L, Tamarozzi R
Radiol Med. 1983 Jul-Aug;69(7-8):527-32.
Renal osteodystrophy is the skeletal response to long-standing chronic renal disease. The radiographic features include hyperparathyroidism (osteitis fibrosa cystica), rickets or osteomalacia, osteoporosis, osteosclerosis and soft tissue and vascular calcifications. Many investigators have verified that changes in the phalanges of the hand are the most sensitive indicator of renal osteodystrophy, especially subperiosteal bone resorption. The hands of 50 chronic dialysis patients were evaluated for at least one year for tuftal resorption (acro-osteolysis), subperiosteal and intracortical bone resorption, and periosteal new bone formation (periosteal neostosis), using fine detail radiography and optical magnification. At last control, only in a group of 17 subjects (34%), xeroradiography of the hand was also performed. Results indicate the importance of the use of fine detail radiography in the early diagnosis of renal osteodystrophy and that serial radiography of the hand is a proper method of evaluating progressive bone resorption. In addition, a significant difference (p less than 0.05) is demonstrated between xeroradiography and radiography to evaluate periosteal neostosis.
肾性骨营养不良是骨骼对长期慢性肾病的反应。其影像学特征包括甲状旁腺功能亢进（纤维囊性骨炎）、佝偻病或骨软化症、骨质疏松症、骨质硬化以及软组织和血管钙化。许多研究者证实，手部指骨的变化是肾性骨营养不良最敏感的指标，尤其是骨膜下骨吸收。对50例慢性透析患者的手部进行了至少一年的评估，采用精细细节放射摄影和光学放大技术，观察指端吸收（肢端骨质溶解）、骨膜下和皮质内骨吸收以及骨膜新骨形成（骨膜骨赘形成）情况。在最后一次检查时，仅对17名受试者（34%）进行了手部干板X线摄影。结果表明，精细细节放射摄影在肾性骨营养不良早期诊断中具有重要意义，手部系列放射摄影是评估进行性骨吸收的合适方法。此外，在评估骨膜骨赘形成方面，干板X线摄影和放射摄影之间存在显著差异（p小于0.05）。
